Diarrhea

Causes

Diarrhea may be caused by:

• Food intolerance, such as lactose intolerance
• Some medicines, such as:
  • Antibiotics
  • Antacids that have magnesium in them
  • Chemotherapy
  • Laxatives
• Irritable bowel syndrome
• Injury to the bowel after radiation treatments for cancer
• Malabsorption syndromes, such as celiac disease
• Diseases of the pancreas or gallbladder
• Inflammatory bowel diseases, such as ulcerative colitis and Crohn disease
• Chronic diseases, such as:
  • Liver disease
  • Diabetes
  • Hyperthyroidism
  • AIDS
  • Colon cancer
• Intestinal surgery
• Infections such as:
  • Bacterial, such as salmonella
  • Viral, such as rotavirus and norovirus
  • Parasitic
  • Fungal, such as yeast

Risk Factors

Things that may raise the risk of diarrhea are:

• Traveling to a country where the water and food supply may be contaminated
• Taking certain medicines
• Being in a hospital
• Having a severely weakened immune system, such as with AIDS or after an organ transplant

Symptoms

A person may have:

• Frequent loose, liquid stools
• Belly pain and cramping
• An urgent need to have a bowel movement
• Blood and mucus in the stool
• Fever
• Nausea and vomiting
• Muscle aches and pains
• Weight loss

When Should I Call My Doctor?

Call the doctor if you:

• Have diarrhea that lasts longer than three days
• Are not able to eat or drink to stay hydrated
• Have a fever

Call the doctor if your young child:

• Has diarrhea that lasts longer than a day
• Has pus in his or her stool
• Does not have wet diapers
• Is crying without tears
• Is unusually sleepy or irritable
• Has a fever

When Should I Call for Medical Help Right Away?

Call for medical help or go to the emergency room right away if you or your child has:

• Severe belly pain and cramping
• Bloody or black stool

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. The doctor may insert a gloved finger into the rectum to examine it. This is called a digital rectal exam.

The doctor may ask some questions to find the cause of diarrhea:

• Does anyone else in the family have diarrhea?
• What kinds of food and drinks have you had?
• Do your children attend daycare?
• Have you traveled recently?
• What is your sexual history?

Blood tests and stool tests may be done.

The rectum and colon may need to be checked. This can be done with:

• Flexible sigmoidoscopy
• Colonoscopy

A biopsy may also be taken.

Images may be taken of the colon. This can be done with:

• Upper gastrointestinal (GI) series
• Barium enema

Barium Enema

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Treatment

The goal of treatment is to ease diarrhea and prevent dehydration. Any underlying cause will need to be treated.

Some treatment options are:

• An oral rehydration solution to replace lost fluids
• Diet changes, such as a clear diet and avoiding foods that trigger diarrhea
• Antidiarrheal medicine
• Probiotics

Prevention

The risk of diarrhea may be lowered by:

• Practicing proper hand hygiene
• Practicing safe food preparation and storage
• Taking care when traveling, such as:
  • Drinking bottled water and avoiding drinks with ice
  • Avoiding foods from street vendors
  • Not eating raw vegetables or fruits
  • Cooking foods well
  • Only eating pasteurized dairy products

Rotavirus is a common cause of diarrhea in children under 5 years of age. The rotavirus vaccine can prevent it.